Nephrostomy catheter with formed tip

ABSTRACT

A nephrostomy catheter comprising, an elongated shaft having a drainage lumen extending along the shaft and a distal end, and a formed tip bonded to the distal end of the shaft and having a distal opening communicating with the lumen to receive a guide wire.

This is a continuation of application Ser. No. 920,324, filed Oct. 17,1986, now abandoned, which is a divisional of Ser. No. 683,056, filedDec. 18, 1984, now U.S. Pat. No. 4,645,490.

BACKGROUND OF THE INVENTION

The present invention relates to catheters.

When the ureter or kidney of a patient is obstructed by a stone, it isnecessary to stabilize the kidney through drainage because an increaseof pressure in the kidney could result in loss of the kidney. Such aprocedure is called a nephrostomy procedure. First, a small gauge hollowneedle is passed under radiologic vision until a tip of the needle islocated in the renal calyces to obtain access to the kidney chamber.With the needle in place, a flexible elongated guide wire is passedthrough the needle, and the needle is removed with the guide wire inplace to establish a path to the kidney. Next, a plurality of dilatorsare inserted over the guide wire in order to increase the size of thepath to the kidney, and the dilators are then removed. In the past, acatheter is then placed over the guide wire, with the catheter having apig tail which is located in the kidney. Although nephrostomy has beencompleted in this manner, it is desired to improve the procedure.

SUMMARY OF THE INVENTION

A principal feature of the present invention is the provision of animproved catheter for performing a nephrostomy procedure.

The catheter of the present invention comprises, an elongated shafthaving a drainage lumen extending along the shaft and a distal end, anda formed tip bonded to a distal end of the shaft.

A feature of the present invention is that the tip has a distal openingcommunicating with the lumen to receive a guide wire.

Another feature of the invention is that the tip has at least onedrainage eye intermediate the opening and a proximal end of the tip inorder to drain urine from a kidney.

Yet another feature of the invention is that the tip defines an innerflat shoulder to receive a distal end of a stylet.

Another feature of the invention is that the elastic sleeve may bebonded to a distal portion of the shaft with a radiopaque adhesive.

A further feature of the invention is the provision of methods forperforming a nephrostomy procedure.

Another feature of the present invention is the provision of a stylethaving a proximal hollow flexible tube to prevent kinking of a guidewire.

Further features will become more fully apparent in the followingdescription of the embodiments of this invention and from the appendedclaims.

DESCRIPTION OF THE DRAWINGS

In the drawings:

FIG. 1 is a diagrammatic view of a kidney of a patient;

FIG. 2 is an elevational view of a needle for performing a nephrostomyprocedure;

FIG. 3 is an elevational view of a guide wire for performing theprocedure;

FIG. 4 is an elevational view of a stylet for performing the procedure;

FIG. 5 is a fragmentary elevational view of a catheter of the presentinvention;

FIG. 6 is a fragmentary sectional view of the catheter of FIG. 5; and

FIG. 7 is an end view of a tip of the catheter of FIGS. 5 and 6.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

Referring now to FIG. 1, there is shown a kidney K of a patient having ahollow renal calyces C. Referring to FIG. 2, there is shown a hollowneedle 10 having a distal sharp tip 12 and a proximal hub 14. Referringto FIG. 3, there is shown an elongated guide wire 16 of flexiblematerial having a distal end 18 and a proximal end 20.

Referring to FIG. 4, where is shown a stylet 22 of the present inventionhaving an elongated hollow rigid tube 24 with a distal end 26 and aproximal end 28. The stylet 22 has a hollow flexible tubular section 30of suitable plastic material secured over the proximal end 28 of thetube 24 for a purpose which will be described below.

Referring to FIGS. 5-7, there is shown a catheter generally designated32 of the present invention. The catheter 32 has an elongated hollowelastic shaft 34 defining a drainage lumen 36 extending through theshaft 34. The shaft 34 has a distal end 38, and a proximal end 40. Asshown, the shaft 34 has an inflation lumen 42 extending through a wallof the shaft 34.

The catheter 32 has a hollow connector 44 secured to the proximal end 40of the shaft 34 and defining a continuation of the drainage lumen 36.The connector 44 has a side arm 46 defining a continuation of theinflation lumen 42 which communicates with a valve 48 of known typewhich actuates by contact of a tip of a syringe. The catheter 32 has anelastic sleeve 50 having its ends bonded to the shaft 34 in spacedcircumferential zones 52 and 54 by a radiapaque material, such as by asuitable adhesive impregnated with a radiopaque material such as bariumsulfate. The bonded sleeve 50 defines a cavity 56 beneath the sleeve 50and communicating with the inflation lumen 42. The catheter 32 may beconstructed from any suitable elastic material, such as silicone.

The catheter 32 has a formed or molded tip 58 bonded to the distal end38 of the shaft 34. In a preferred form, the tip 58 is made from aradiopaque material, such as by impregnating a suitable plastic withbarium sulfate. The tip 58 has an opening 60 extending through a distalportion of the tip 58 and communicating with the drainage lumen 36 for apurpose which will be described below. The tip 58 also has a pluralityof drainage eyes 62 extending through the tip 58 and communicating withthe drainage lumen 36 at a location intermediate the opening 60 and aproximal end of the tip 58. Also, the tip 58 defines an inner flatshoulder 64 for a purpose which will be described below.

In performing a nephrostomy procedure, first the needle 10 is passedunder radiologic vision until the tip 12 is located in the renal calycesto obtain access to the kidney chamber. With the needle 10 in place, theguide wire 16 is passed through the needle 10 until the distal end 18 islocated in the renal calyces, and the needle 10 is removed with theguide wire 16 in place to establish a path to the kidney K. Next, aplurality of dilators are inserted over the guide wire in order toincrease the size of the path to the kidney, and the dilators are thenremoved.

Next, the stylet 22 is placed in the drainage lumen 36 of the catheter32 until the distal end 26 of the stylet 22 engages the shoulder 64 ofthe tip 58 in order to facilitate insertion of the catheter 32. Thecatheter 32 and stylet 22 are then passed over the guide wire 16, withthe guide wire 16 extending through the opening 60 and a lumen in thestylet 22. During this time, the stylet 22 provides rigidity for thecatheter 32 to facilitate the insertion procedure. The tubular section30 of the stylet 22 prevents kinking of the guide wire 16, and cuttingof the physician's glove by the tube 24. The catheter 32 is passed overthe guide wire 16 until a distal end of the catheter 32 is located inthe renal calyces C. The distal portion of the catheter may bevisualized on a fluoroscope due to the radiopaque tip 58 and bondingzones 52 and 54 of the sleeve 50. Next, a syringe may be utilized toactuate the valve 48, and a suitable fluid is pumped by the syringethrough the actuated valve 48 and inflation lumen 42 into the cavity 56which holds approximately three cubic centimeters of fluid in order toinflate the sleeve 50 in the renal calyces C. In a preferred form, theinflation fluid comprises a radiopaque medium 66 to assist observationof the distal portion of the catheter 32 by a fluoroscope. Afterinflation of the sleeve 50 in the renal calyces C, the stylet 22 isremoved from the catheter 32, and a drainage tube (not shown) connectedto a drainage bag (not shown) is attached to the connector 44, such thaturine drains through the catheter and drainage tube into the urine bagfor collection therein. In this manner, the nephrostomy procedure isperformed with the catheter 32 and stylet 22 of the present invention.

According to a method of performing a nephrostomy procedure of thepresent invention, a guide wire is placed in a patient's body with adistal end of the guide wire located in the renal calyces, a catheter isadvanced over the guide wire until a distal portion of the catheter islocated in the renal calyces, and a balloon of the catheter is inflatedin the renal calyces.

The foregoing detailed description is given for clearness ofunderstanding only, and no unnecessary limitations should be understoodtherefrom, as modifications will be obvious to those skilled in the art.

I claim:
 1. A nephrostomy catheter assembly, comprising:an elongatedshaft having a drainage lumen extending through the shaft, a distal endand an inflatable sleeve adjacent the distal end and attached to theshaft, and means for inflating the sleeve; a formed tip bonded to adistal end of the shaft and having a distal opening communicating withthe lumen to receive a guide wire, said tip defining an inner flatshoulder; a hollow elongated stylet removably received in the drainagelumen of the catheter with a distal end defining a distal edge of thestylet engaging against the tip shoulder without passing through theopening; and an elongated guide wire received in and in direct contactwith the stylet and passing through the tip opening.
 2. The catheter ofclaim 1 wherein the tip has at least one drainage eye intermediate theopening and a proximal end of the tip, said drainage eye communicatingwith the drainage lumen.
 3. The catheter of claim 1 wherein the tip isradiopaque.